Organization Active NPI

Elmhurst Memorial Interventional Radiology Services LLC

  • Vascular & Interventional Radiology Physician
  • Elmhurst, IL
National Provider Identifier
1669641080
Registry record updated Feb 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
ELMHURST MEMORIAL INTERVENTIONAL RADIOLOGY SERVICES LLC
Practice address
200 N Berteau Ave
Elmhurst, IL 60126-2966
Phone
(630) 833-1400
NPI assigned
Feb 29, 2008
Last updated
Feb 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Andrew S Blum, M.D.NPI 1629020532
Title
President
Phone
(630) 833-1400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0204X IL Primary

Addresses

Primary practice location

200 N Berteau Ave
Elmhurst, IL 60126-2966

Mailing address

520 E 22ND St
Lombard, IL 60148-6110
Phone (630) 874-2542

National Provider Directory

National Provider Directory

Locations

Dept 4598
Carol Stream, IL 60122

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204243200000",
    "number": "1669641080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 E 22ND ST",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486110",
            "telephone_number": "630-874-2542",
            "fax_number": "630-960-0227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N BERTEAU AVE",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262966",
            "telephone_number": "630-833-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELMHURST MEMORIAL INTERVENTIONAL RADIOLOGY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-29",
        "last_updated": "2008-02-29",
        "status": "A",
        "authorized_official_last_name": "BLUM",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-833-1400",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.